iHeal

For soldiers dealing with PTSD and other issues, the military has endorsed a novel treatment: a form of mindful meditation known as iRest

By Archana Pyati

| Published: 2013-03-04 17:21

Ben King’s troubles began with severe pain in his shoulders and neck. Assuming that his bed was causing the discomfort, he tried three different mattresses without any relief.

A few months later, he started to feel crushing anxiety when he tried to fall asleep at night.

It was 2008, and the former Army sergeant had been home for less than a year after serving in the Iraq War. The euphoria he felt immediately upon his return had given way to mood swings and crying fits, often triggered by nothing more than an offhand comment from his fiancée.

“It would be the littlest of things that would turn into this cataclysmic event,” says King, 32, who lives in Friendship Heights with Alena, 31, now his wife. “And I just couldn’t do anything about it.”

King became adept at self-medicating, drinking heavily and taking Tylenol PM for his insomnia. Leery of prescription drugs, he began experimenting with nonmedical approaches, including yoga classes at the gym where he worked as a personal trainer.

Yoga lessened the physical pain, but King still sought an end to the emotional turbulence that had become part of his daily life. A friend suggested a guided meditation class tailored specifically for soldiers at the Washington D.C. Veterans Affairs Medical Center. Known as yoga nidra, this meditation practice is among the alternative therapies the military has endorsed in recent years to help veterans deal with post-traumatic stress disorder (PTSD), chronic pain and insomnia.

King began attending the class early last year, learning techniques to separate himself from the negative thoughts related to his time in a war zone. He began drawing parallels between preparing for combat and preparing for life after combat.

“I started to see more clearly how my mind could be influenced by training similarly to the way my body could be influenced by training,” King says.

In 2006, the military was curious enough about yoga nidra that the Department of Defense conducted a study at the Walter Reed Army Medical Center in Northwest D.C. (now Walter Reed National Military Medical Center in Bethesda). The study explored its impact on soldiers returning from Iraq and Afghanistan who had been diagnosed with PTSD.

The department then asked psychotherapist Richard Miller to develop a yoga nidra protocol specifically for the military. Miller is a pioneer in understanding how mindful meditation can heal trauma and is founder and executive director of the California-based Integrative Restoration Institute.

Miller and military leaders renamed the practice “integrative restoration,” or iRest, a term they agreed would better fit military culture. Active duty soldiers and veterans are now practicing iRest at military hospitals throughout the country, including Walter Reed in Bethesda and the VA Medical Center.

For those at the forefront of the movement to incorporate holistic approaches into military medicine, the idea is this: to get soldiers to think about their war trauma in a different way. It doesn’t define who they are, and isn’t a pathology that needs to be cured.

Instead, trauma is a life experience that soldiers need to integrate—just as iRest suggests—into a larger sense of themselves, says Silver Spring yoga instructor Robin Carnes. She taught iRest for six years in the Specialized Care Program, an intensive therapeutic process for soldiers returning from Iraq and Afghanistan that was offered at Walter Reed’s Deployment Health Clinical Center (DHCC).

Numerous studies are under way to pinpoint iRest’s impact on reducing symptoms of PTSD among military personnel, according to the Integrative Restoration Institute. In 2010, the War Related Illness and Injury Study Center at the VA Medical Center surveyed 164 veterans who were attending iRest sessions. The results were promising: 85 percent reported moderate improvements across 13 different symptoms, including disturbing memories, headaches, irritability and angry outbursts.

“What iRest does is that it allows the nervous system to go back to the…resting and restorative state,” Carnes says. “Once you have that capacity to de-escalate the nervous system, then you can bring the trauma back in. We invite the trauma into the meditation while we’re in a de-escalated state.”

For soldiers, memories of combat lead to painful second-guessing—what they did or didn’t do, whom they killed or didn’t save, the orders they should or shouldn’t have followed—and the need to avoid situations where those memories might be stirred up again.

Army psychologist Capt. John Golden once treated a patient in the Specialized Care Program who compared his mental state to a deck of cards—each with a vivid picture or a memory from his war experiences—being flipped and thrown back in his face. A trip to the mall or any crowded place, or criticism from a loved one could trigger a “fight or flight” response, says Golden, who directed the Specialized Care Program at Walter Reed.